Department of Pulmonology, Semmelweis University, 1/C Dios arok, Budapest, 1125, Hungary.
Department of Radiology, Semmelweis University, 78a Ulloi ut, Budapest, 1082, Hungary.
Lung. 2018 Aug;196(4):417-424. doi: 10.1007/s00408-018-0120-z. Epub 2018 May 8.
Obstructive sleep apnoea (OSA) is characterised by a low-grade systemic and airway inflammation; however, the regulatory mechanisms of inflammation are poorly explored. Survivin (Birc5) is an anti-apoptotic protein which inhibits Type 1 inflammation; however, this molecule has not been investigated in OSA.
Forty-five patients with OSA and 31 non-OSA control subjects were involved. Venous blood was collected for plasma survivin measurements before and after diagnostic overnight polysomnography. Plasma survivin levels were compared between the two groups and correlated to OSA severity and comorbidities.
Plasma survivin levels were lower in OSA in the evening (27.6 ± 89.9 vs. 108.3 ± 161.2 pg/ml, p < 0.01) and in the morning (17.4 ± 48.6 vs. 36.4 ± 69.2 pg/ml, p = 0.02) compared to the control group. This OSA-related decrease was also present when only the non-obese patients were analysed. Significant indirect relationships were observed between plasma survivin levels and measures of OSA severity such as the apnoea-hypopnoea index (r = - 0.45) or oxygen desaturation index (r = - 0.40, both p < 0.01); however, when adjusting to BMI, these became insignificant (p > 0.05). Low plasma survivin concentrations were associated with high BMI (r = - 0.35), high CRP (r = - 0.31), low HDL cholesterol (r = 0.24) and high triglyceride levels (r = - 0.24, all p < 0.05).
Plasma survivin levels are reduced in OSA, relate to disease severity, and are associated with high CRP levels. This suggests an impaired immunoregulation in this disorder which needs to be studied in further detail.
阻塞性睡眠呼吸暂停（OSA）的特征是低度全身和气道炎症；然而，炎症的调节机制仍未被充分探索。Survivin（Birc5）是一种抗凋亡蛋白，可抑制 1 型炎症；然而，这种分子在 OSA 中尚未被研究过。
纳入 45 例 OSA 患者和 31 例非 OSA 对照组。在诊断性整夜多导睡眠图前后采集静脉血以测量血浆 survivin。比较两组间的血浆 survivin 水平，并与 OSA 严重程度和合并症相关。
OSA 组傍晚（27.6±89.9 与 108.3±161.2 pg/ml，p<0.01）和清晨（17.4±48.6 与 36.4±69.2 pg/ml，p=0.02）的血浆 survivin 水平均低于对照组。当仅分析非肥胖患者时，也存在这种与 OSA 相关的降低。血浆 survivin 水平与 OSA 严重程度的测量指标如呼吸暂停低通气指数（r=-0.45）或氧减饱和度指数（r=-0.40，均 p<0.01）之间存在显著的间接关系；然而，当调整 BMI 后，这些关系变得无统计学意义（p>0.05）。低血浆 survivin 浓度与高 BMI（r=-0.35）、高 CRP（r=-0.31）、低 HDL 胆固醇（r=0.24）和高甘油三酯水平（r=-0.24，均 p<0.05）相关。
OSA 患者的血浆 survivin 水平降低，与疾病严重程度相关，并与高 CRP 水平相关。这表明该疾病的免疫调节受损，需要进一步详细研究。
